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tv   Washington Journal Primetime Dr. Kristin Englund  CSPAN  March 26, 2020 4:25am-5:06am EDT

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stimulus bill that is expected to be considered in the house. 10:45 verage begins at eastern on c-span. follow the federal response to at coronavirus outbreak congress, white house briefings, and updates from governors, track the spread from and the world. watch on demand any time, nfiltered at with the to begin latest from john hopkins university, and the latest coronavirus exceeding 466 cases across the world. in the us. s we have surpassed more than the epicentre nd of all of this is new york city. the r is joining us from cleveland clinic in ohio. thank you for being with us on
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"washington journal." >> thank you very much. >> i want to go to the map from and point out on march 1st. new york city had one case of coronavirus. my question is this has spread so quickly, rapidly across the country. well, we know that unlike pass nza, where you can the inspection from yourself to maybe one other person, the the coronavirus can be spread more easily to 2-3 other people. have doubled the amount of people that you can expose to the virus. so in a city as dense in is, ation as new york city obviously so many more people can get exposed to one person. then, obviously, we have transportation, airlines, flying all different parts of the country, so the virus can spread to allckly parts of the country. >> quickly, it can be people. ed people to
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how long can it live without a host. >> right. spread by droplets, you can cough on someone and expose directly or someone could cough on to their hand and put on a doorknob.r estimates are show egg if it's plastic or steel, the 2-3 remain if it's porous, cardboard or a er, it's there for a hours. few hours. think of all the times throughout the day you reach for a door handle. and it could harbour a virus. >> there's talk about transmitting blood from patients to be used as a form of treatment. explain how what would work. >> sure, when one the immune makes antibody, when omeone recovered from the
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inspection, the body remains the antibodies. get plasma from the patients and be able to that. t the antibody from and infuse that into patients that were ill with it, so they proteins to fight the virus. issue is the vaccine, it was indicated it will take a year for the do you see the time period shortened in any way. a yeari see it will take to get a viable vaccine out. and produced. cleared through the f.d.a. and used on the american public. t takes that long, unfortunately for vaccines, you as at other vaccines, such measles, it took 40 years to evelop vaccinations for some viruses, this is a quick a viral around for infection. >> as far as treatment we here a
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about chloro-quin and others. plaint the significance of that. number of people getti rapidly ill in all parts of the world. people have been trying all they think of. there's few randomized trials where we looked at the i give theand say if person medicine or don't. one is going to get better and other is not. so there are controlled trials hat we want to do with medications to tell clearly that the medication is effective. have that information available and unfortunately some of the medications that are this point in time. as significant side effects so we have to weigh whether against not having the information that it's going to help them. going to do e patients
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it is also going to be ongoing in clinical trials. we do sometimes give antibiotics to patients who give covid -- who have covid in case they have weacterial infection, but are not looking to treat the virus at that time. [laughter] -- host: what are you seeing in cleveland? guest: we are seeing our numbers increase across cleveland. we have patients on the floor
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and in the intensive care units. we are not nearly up to the levels they are seeing in new didn't see oure first case in cuyahoga county until march 9, so we are at least a week behind their timetable. we are bracing for next week or the week after. how are you personally planning for this and how do you take care of the patients? guest: the cleveland clinic has taking aod job of clear track. the ventilators that we have. the amount of bed space we have. they have plans to be able to ramp that up very quickly. the plans are in place. we are trying to limit the amount of personal protective equipment being used for other
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things throughout the hospital, so we and all other hospitals in ohio have cut out nonessential procedures and surgeries. for each of those, masks and downs will be needed so we are moving those into the front line so we can have those to protect and prepare our caregivers on the front lines. host: we are here to take your calls. let me follow-up with one other point. what does the next month look like for you and this illness? guest: the next month will be a challenge for all americans. it will be a big challenge for us in the medical field to take care of our patients. it will get worse before it gets better. host: let's go to jim in south bend, indiana. caller: thank you. you have a lot of courage.
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guest: you are very kind. caller: god bless you. this is addressed to you and my congressman hollingsworth. we have almost 100 million americans are underinsured for health care. this problem is no longer the people that cannot afford health care, that is their problem. now it is all of america's problems because those that cannot afford and access health care is split up around the entire country. i wonder if the congressman still wants to repeal obama care. thatillion americans cannot afford health care, how is this complicating the covid issue? host: how is the cleveland clinic handling this? guest: patients with poorly
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controlled diabetes, lungtension, obesity, disease like copd or emphysema are at much higher risk for having severe complications from covid-19, so when you talk about folks who may not be taking appropriate care of their underlying diseases because they are underinsured, that will play into this. illness andmore those folks with uncontrolled illness. in, weow, patients come do not look at their insurance card. we are taking care of them. hospital systems across the country are going to have to look into this. the government will have to assist. host: perhaps a silver lining in all of this could be that americans need to do a better job of washing their hands. you are mentioned in a study that indicated that only 5% of those surveyed used the bathroom
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and washed their hands appropriately enough to kill the germs. 33% did not even use soap. men worked particularly bad at washing their hands correctly. guest: you are right. we have to look for these silver linings. this is hopefully a great way for people to understand the importance of being too transmit this and block the transmission against others, certainly in our households, being careful around those with underlying health care issues or over the age of 60. it is very important that we do everything we can to protect them. if you are sick, please do not go around anyone who is sick or elderly. wash your hands. we need to do everything we can to protect. the other thing we need to do, not just washing our hands but touching our face.
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when you look at studies of how frequently we touch our face, it is like 20 times in an hour people touch their face. i have my hands down here. there is always a temptation to want to do that, especially when you are under stress. we are all under stress now. peggy from washington state. caller: good evening. i wanted to talk about an article i was reading. there are two types of this coronavirus, the s type and the l type, which is more aggressive. caused a mutation of the ancestral version of the virus and that could mean that more are coming. we should quote an urgent need for further comprehensive combinethat could general data and epidemiological data and chart the critical systems of patients.
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host: thank you for the call. guest: there is so much for us to learn about this coronavirus at this point in time. research labs will be studying this virus for years to come. right now the very basic tests lines canon the front tell us whether a patient has coronavirus, yes or no. covid-19.r it is there are other coronaviruses that are around. some can cause regular cold symptoms symptoms. -- cold symptoms. and what we are finding with this current coronavirus is there may be some subtle differences but there is not a lot of information with different strains. not yet, more to come. host: why do you study and practice infectious diseases? guest: that is a great question. we train especially for this,
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kind of a problem. i trained early on at northwestern when there was the hiv epidemic and i find it fascinating, watching my colleagues and seeing who is going to step forward in a crisis. those of the people i wanted to model after. this is when i see them step forward again. host: we appreciate your time this evening. a physiciand by from scottsdale, arizona. caller: thank you so much for taking my call. about the concern current definition of cases is that we are lumping together people who have been exposed and people who have pneumonia. i think that is the biggest problem we have with this definition of cases is until we recently started to test people for the virus is when we learned
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people had some genetic material in their bodies but did not have pneumonia. i think it is extremely important for the country to understand how we separate cases of pneumonia versus cases of exposure. learned that hiv was the source of the virus, then we were able to separate cases. i think we will see a decrease in the cases of pneumonia and have a better understanding of how the virus in reality affects those people who have been exposed, because at this point in time it is too early for us to have the knowledge of the diagnosed asybody cause -- carlos -- caused by the sars virus. guest: we have so much more to learn about this disease.
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you are absolutely right. some people get exposed to the virus and can be carriers but do not necessarily show the disease and then there are some people who get critically ill and unfortunately even die with this. we need to figure out what are the reasons why some people survive and some do not. we only have the most experience coming out of china where we were able to look at some of the disease cases that were underlying and the people who got sicker without. we had problems -- sicker with that. diabetesoblems with and heart disease and lung disease. we have a lot to learn. this is only been around for a few months. we are trying to learn from those we can. we can look forward to getting a better understanding of this virus. host: we welcome our listeners on c-span radio every morning
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taking your calls. hours, we appreciate youate you joining us for an evening edition. mike is on the phone from cleveland, ohio. caller: much respect and thank you for the way you approach your forthrightness with the way you approach the virus and so on. i am in southwestern cleveland, not far from you. in addition to all the steps, the handwashing, the social distancing and everything else, i am unemployed and have plenty of time on my hands. governor cuomo has asked for an all hands on deck. is there anything citizens can do to help out the community or the hospitals right now? guest: such a wonderful question, and thank you for wanting to help out. one of the biggest things we can ours reach out to those in community who might be alone,
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might be elderly, might not have someone to check in on them, and make sure they are staying safe. look around your neighborhood and find out if there is an older woman who lives alone who might not be able to go out to get groceries at this point in time or make a phone call to her basis just to make sure, are you feeling ok? this is a great opportunity for us to show as americans that we will stand together and we will take care of each other. thank you for wanting to help that out. host: from washington state, keith, welcome to the conversation. caller: thank you for taking my call. i have a question on the n95 masks. i am 64 and i have copd. i have had to go out for groceries and i have a very .mall supply of the n95 i have seen other countries,
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everyone wearing them. when i am out getting groceries, which has been once in the last week, i see no one with masks. do they protect you and can you clean them so they have more life? guest: that is an important question. masks are a challenge. it is very tempting to want to put something on to protect yourself from the virus. i hear that and i understand that, but the data does not show that they give you any protection whatsoever. the main thing that protects you is washing your hands and not touching your face. a mask gives you a false sense of security. it is helpful if someone is orghing right on your face especially if someone has covid, which is why we need the masks for those in the intensive care unit who will be caring for patients and cannot maintain the six foot social distancing and
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care for their patients. i suggest when you go out to the grocery store, try to find times when there are not a lot of people there. some grocery stores have times immunocompromised issues so they can shop before. they know they are more at risk. see if your local grocery store set up times for older people. masks are not going to afford you any kind of protection. host: if you are living with someone who may have symptoms, might have been tested, not yet confirmed what should they do? , guest: when someone has symptoms but they have not been tested positive the most , important thing to do is to do self-quarantine. they are going to try to stay as far away from other family members as possible. if they are coughing, if we
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could get a mask it would be helpful. we do not want you to cough and spread the droplets onto the rest of the household for people to touch. try to limit the number of locations in the household that person is exploring or going out to. see if they could have a bathroom to themselves. for the rest of the household, make sure they are touching base with that person on a daily basis, and the rest of the house should be using appropriate cleaning supplies if the person under investigation touches them. host: how long do those droplets survive on a countertop or a chair? guest: if it is a chair that has a steel handle to it, it can stay on for three days. on a countertop it depends on , what the countertop is made out of. i think days is a reasonable amount of time, so countertops and surfaces should be cleaned
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at least once a day. host: carmen is next in new jersey. caller: hello. i remember many years ago doctors and he nurses use to use cloth masks when dealing with patients. i am wondering if that was something that was just not reliable because that was something that could be washed and sterilized and reused. i don't know if the reason we stopped using them is because they are not as effective. it seems that some of these masks are threefold, there is three layer's the droplet would have to go through. my other question would be it , seems that people with stronger immune systems can survive this without getting very sick or passing away. then somebody with a weaker immune system and maybe why it is attacking or doing more damage to the elderly.
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and people with these underlying conditions like the man that passed away under 50 who had been diagnosed with cancer. host: thank you. first let me take the question, the cloth masks. that has been another hot topic of information. we don't feel that cloth masks will be of substantial benefit. if somebody is coughing and wants to put on a cloth mask to protect those around them, it protect the larger droplets, but they really do allow small droplets to be able to penetrate through. if i have a cloth mask on and someone coughs on me, it is likely i will be exposed to that virus. while folks are making cloth
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masks to help out there is not a , lot of evidence that cloth masks will be helpful. to answer the second question folks who are older oftentimes , do have other complicating medical illnesses. you mentioned the cancer in that one patient who was infected and passed away. as we get older, our immune system starts to get weaker as time goes. however that does not mean that , people in their 20's, 30's, 40's, and 50's are immune to this. not by any way, shape, or form. everybody needs to be careful and practice social distancing, wash their hands. no one is immune from this. even if you think you are only going to get a mild infection if , you want to go to a beach and hang out with your friends, be very careful when you go home. you're going to expose your parents and your grandparents. everybody needs to take care of each other. host: martha in belleville,
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ohio. my concern was i am over , 70. i am listening to all of this and i am concerned about how close is this to polio? guest: that is a very interesting question. polio is another virus. it can also be spread respiratory secretions. it causes a very different clinical syndrome as you know from the muscle weakness that progresses to people potentially having a paralysis of their diaphragm, the muscle to help us breathe. it certainly is comparable in the way that we treat it, they did social distancing back in the 1940's and 1950's as well. i remember hearing stories of beaches being closed down people , not able to have birthday parties and congregate together.
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the way they started to treat polio was a lot of what we are trying to do here. i do see similarities. host: another caller from ohio. painesville, heather. caller: i am a nurse. i have severe asthma. i would be put in a situation where i would have to care for a covid-19 patient. i was wondering if there was anything that could prohibit me safe and my myself patients safe as i do have , difficulty wearing the mask. guest: thank you for your service. that is something you would need to discuss with your employer. as far as whether they have options for you to be able to maintain your job or do it in a different venue. they have a lot of the virtual calls and visits that we are doing. i would suggest you talk to your
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manager and find out from them what are your other options at work. host: dr. fauci referred to this as the flu on steroids. one of the symptoms, difficulty breathing. what is it about the virus that makes it difficult for you to breathe? guest: the virus attacks the different cells within the lungs and allows water to be able to enter into the cells. as a result, the lungs basically get flooded. that is what makes it so difficult. patients report feeling very weak. overall because of their fatigue, it makes it difficult for them to take a deep breath. host: are there any long-term implications from this virus in terms of your lungs? guest: that is something we will learn about. folks who are on ventilators and have severe damage to the lungs oftentimes do have long-term effects. we are also starting to see that there may be some effect on the heart, as the virus itself can
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cause damage to the heart. we don't understand why that damage is being caused, is the virus itself invading the muscle of the heart or is it causing more vascular problems? in a few years we will start to see repercussions from this for our surviving patients. host: she is an infectious disease physician. john is next from washington. caller: i was listening to the presentation by president trump earlier in the day. i think one of the clear things is we need to have open communication. as a photographer, i noticed there are a number of still photographers in the background. they have their cameras set for the maximum number of clicks and the highest possible volume, which makes the whole thing very annoying. as responsible journalists, i think that c-span and everybody
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else has a responsibility to tell those people to turn those things off, even though they can,trump, as much as they or get them out of the room. host: it is an open event. we covered the briefings. dr. fauci and deborah birx were only there to give information. we cannot control what happens inside the venue. let me ask you about these briefings and what the american people are learning from experts. -- guest: the hiv epidemic, so this guy knows viral infections better than anyone. i have not heard anything about
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him trying to count his feelings. he seems to be speaking from the heart and with a tremendous amount of knowledge behind him. host: louisiana is now one of the new epicenters and many people attribute that to mardi gras. can you explain? guest: i don't know necessarily what the restrictions were around mardi gras, the time of that. gatherings ofarge people as there usually are at mardi gras that is a perfect , opportunity for people to come from all parts of the country and to be close together at the parade and spread the virus. know there cane be higher levels in the south with diabetes and uncontrolled hypertension, so a lot of these folks in the louisiana already having uncontrolled other them tos that led
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potentially getting the virus and spreading it. host: a few more minutes with our guests. from crowley, louisiana, good evening. guest: my question is a simple one. citizen and i have -- i heard a lot of the covid-19 deaths are caused by pneumonia. what does the shot protect us from? guest: that is a great question. we get so many different vaccines to protect you against a number of infections. we talked a little bit earlier about the difference between bacterial infections and viral infections, the vaccine you received is against the pneumococcal pneumonia. that can cause infections in older and compromised patients.
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that will not offer any protection against covid-19 just , like the flu vaccine is not going to protect you against covid-19. we are looking for a vaccine specific to covid-19. if you had the pneumonia vaccine, you did do a great job of protecting your lungs against that bacterial infection because if you got a bacterial infection and bacterial pneumonia that , would make you at risk for contracting the virus because your lungs would be compromised. host: are you surprised we are at this point with this virus in the united states? guest: when i looked at this were that my hopes this was something that would be able to be contained. as we saw it start to spread and the first case and washington and it started to move, eyes still had some hope but deep , inside i knew this was going
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to take off and would be something bad. this is a type of virus we have never seen. it is truly novel, this kind of coronavirus. having never seen it before, there is no one with antibodies. it is difficult to find a way to stop it and wall off around it. it has gotten to this point? absolutely. am i surprised? unfortunately, no. host: from outside of cleveland, good evening. caller: good evening. i want to ask a question for the doctor about the covid-19. guest: yes, ma'am. to understand,d what is the difference between covid-19 with the other virus murphy?, stars and
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guest: the difference between covid-19, and the infections we had in 2004, sars and mers, all and each of virus them falls under the family called coronaviruses. mers infected very few people around the world, several thousand. now we are talking about hundreds of thousands of people with the current coronavirus. this is much more easily transmittable. it affected a much smaller number. stars and mers were much more deadly so you -- sars and mers were much more deadly. coronavirus,ent 600 15,000 people currently infected across the world and
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the current death rate we are seeing is about 3%, where the death rate for something like influenza is about 1%, so three with theople may die current virus. in 1000. is about one host: katie joining us from gilder lander, new york. caller: i have two questions. could you get it from money because money goes through so many hands? , couldther question people get that from smoking marijuana? that goes through god only knows only hands.
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of one thing to think about his coins. coins are made out of metal. being able to hold onto this for several days. idea afteris a good you've been handling money at a make sure you're using hand sanitizer and certainly before you touch your face. for the second question about , i do not think we have had any studies i've been able to see that have looked into whether it is actually in marijuana. certainly there of been potential talks about whether might havevape caused some injury to their lungs and whether that might make them susceptible to
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disease. we know smoking tobacco can. i would think that smoking marijuana would also cause compromise to your lungs but that is my opinion and i did not have data to back that up. host: let me conclude by asking about what is happening in ohio. the governor has been among the most aggressive in the country shutting down schools, large gatherings, non-essential businesses. explain why that is important and what you expect to see in in .he coming days and weeks tremendousve a amount of respect for governor dewine and dr. amy acting who have done a tremendous job trying to protect ohio from the spread of disease. closing down the schools is tremendously important in making sure we do not have kids spreading it back and forth. i can talk handwashing and not touching your face to a bunch of
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adult and they may not necessarily follow my instructions but i can guarantee a bunch of five-year-olds will not be following those instructions. it is difficult for kids to understand that. it is much more likely they will be spreading it in their schools. closing that down was very important. calling for the closure of all nonessential surgical practices, dental practices, all of that has been important and us being able to prevent or protect the limited personal protective equipment we have was very important. certainly closing a lot of venues. i know it is hard when you cannot go to the concerts or football games. areas where we are close together is where we can pass the virus around. social distancing is terribly important. to be able to go door concert and remain six feet apart from everybody else is difficult. close the venue and let us
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protect you as best we can. i think they have done a great job of trying to stem the tide of infection. hopefully we are better position than we would be if this was not done, but it is still coming our way. host: how are you and your family personally dealing with all of this? guest: my family is very understanding. we have been honest about the work i do and the work my husband does. he is an internal medicine doctor. my children are home from college, so if there's any blessing i get to see them every day and i do not have to worry about them getting sick in college. we are in this together. dr. kristin england is an infectious disease physician joining us from the cleveland clinic in cleveland, ohio. we thank you for being with us and we would love to have you on again. this has been a fascinating conversation. guest: thank you so much.
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c-span's washington journal live every day with news and policy issues that impact you. coming up, detroit news washington correspondent keith lange discusses the effect of the coronavirus pandemic on the u.s. auto industry. then the former nevada republican congressman and current chair of the national commission on military, national, and public service talks about national service and the coronavirus pandemic. and katie williams on the defense reduction act and its potential use during the pandemic. watch "washington journal" live at 7:00 eastern. join the discussion. on wednesday, the senate passed a $2 trillion coronavirus economic stimulus bill, the largest emergency aid package in u.s. history.
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the bill passed by a vote of 96-0. the plan has four main components. direct cash payments to individuals, federal relief for small businesses, targeted lending to industries impacted by the pandemic, and funding for hospitals and health centers. the house is expected to take up the bill when they return friday at 9:00 eastern. watch live gavel-to-gavel coverage of the u.s. house when they return on c-span. >> russian president vladimir putin delivered remarks on his country's response to the coronavirus pandemic. he talked about steps his government was taking to provide economic relief, including bolstering social safety net programs, providing direct cash payments to families, and boosting small and medium businesses. president putin also announced the country would


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